DOT Form 224-698

Revised 03/2018Page 1

Permit No. / Click or tap here to enter text. /
Applicant – Please print or type all information
Application is Hereby Made For: / ☐General Permit (No Fee)
☐General Permit $2.50 (Subject to RCW 47.12.140(2))
Intended Use of State Right of Way is to Construct, Operate, and Maintain a:
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on a portion of State Route Click or tap here to enter text. (at/from) Mile Post Click or tap here to enter text.to Mile Post Click or tap here to enter text.inClick or tap here to enter text. County,
to begin in the Click or tap here to enter text. Section Click or tap here to enter text. Township Click or tap here to enter text. North:RangeClick or tap here to enter text. West/East W.M.
and end in the Click or tap here to enter text. Section Click or tap here to enter text. Township Click or tap here to enter text. North:RangeClick or tap here to enter text. West/East W.M.
This Permit is issued pursuant to the applicable terms of RCW 47.32.110 (Roadside Users) and RCW 47.12.140 (Sale of Timber and Removal of Nonmarketable Materials).
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Applicant (Referred to as Grantee) / Applicant Authorized Signature
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Address / Print or Type Name
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City / State / Zip Code / Title
Click or tap here to enter text. / Dated this Click or tap here to enter text.day of Click or tap here to enter text. , Click or tap here to enter text.
Telephone
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Applicant Reference (WO) Number / Federal Tax ID Number or Social Security Number
Authorization to Occupy Only if Approved Below
TheWashingtonStateDepartmentofTransportationreferredtoasthe“Department,”herebygrantsthisPermitsubjecttothetermsandconditionsstatedintheGeneralProvisions,SpecialProvisions,andExhibitsattachedheretoandbythisreferencemadeaparthereof:Constructionfacilitiesproposedunderthisapplicationshallbeginwithinoneyearandmustbecompletedwithinthreeyears fromdateofapproval.
For Department Use Only
Exhibits Attached / Department Approval
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Title: Click or tap here to enter text.
Date: Click or tap to enter a date.
Expiration Date: Click or tap to enter a date.

GeneralProvisions

NochangestotheseGeneralProvisionsmaybemadewithoutfurtherapprovaloftheOfficeoftheAttorneyGeneral

ThisPermitisissuedpursuanttotheapplicabletermsofRCW47.32.110(RoadsideUsers)andRCW47.12.140(SaleofTimberandRemovalofNonmarketableMaterials).

DOCUMENTS,NON-EXCLUSIVE,COMPLIANCEWITHLAW,WORK

  1. AcopyofthisPermitmustbeonthejobsite,protectedfromtheelements,atalltimesduringanyPermitteeactivity,constructionorimprovementWorkasauthorizedbythisPermit.“Work”underthisPermitshallincludetheuseofthestate-ownedrightofwayasauthorizedherein.
  2. ThisPermitshallnotbedeemedorheldtobeanexclusiveoneandshallnotprohibittheDepartmentfromgrantingrightsoflike orothernaturetootherpublicorprivateentities,norshallitpreventtheDepartmentfromusinganyofthestate-ownedhighwayrightofwayorotherpropertiesfortransportationpurposes,oraffecttheDepartment’srighttofullsupervisionandcontroloverallorany partofthestate-ownedhighwayrightofwayorproperties,noneofwhichisherebysurrendered.
  3. ThePermitteeshallberesponsibleforcompliancewithallfederal,state,andlocallawsandregulations.
  4. UponapprovalofthisPermit,thePermitteeshalldiligentlyproceedwiththeWorkandcomplywithallGeneralandSpecialprovisionsherein.

DEPARTMENTNOTIFICATION:SURVEYMONUMENTS,HIGHWAYSIGNS,FENCES,LANDSCAPING

  1. ThePermitteeshallcontacttheDepartmentrepresentative(s),listedinExhibitA,SpecialProvisions,two(2)weekspriortoconductingWork,todeterminethelocationofsurveycontrolmonumentswithintheareainwhichthePermitteewillbeworking.Intheeventanymonumentorrightofwaymarkerwillbealtered,damaged,ordestroyedbythePermittee,theDepartment,priortoPermitteeWork,willreferenceorresetthemonumentorrightofwaymarker.DuringtheWork,upondiscoveryofamonumentor rightofwaymarker,thePermitteeshallceaseWorkinthatareaandimmediatelynotifytheDepartmentofthediscovery.TheDepartmentwillcoordinatewiththePermitteetoensurethatthemonumentorrightofwaymarkerisrecordedorreplaced.ThePermitteeagreestopayallDepartmentactualdirectandrelatedindirectcostsandexpensestoperformmonumentorrightofway markerwork,pursuanttotheprovisionsofSection18-InvoiceandPayment.
  2. Intheeventanymilepost,fence,orguardrailislocatedwithinthelimitsofthePermittee’sWorkandwillbedisturbedduring PermitteeWork,thePermitteeagreestocarefullyremovethesehighwayfacilitiespriortoPermitteeWorkandresetorreplacethesehighwayfacilitiesafterthePermitteeWork,totheDepartment’ssolesatisfactionandatthesolecostofthePermittee.ThePermitteeshallnotremoveordisturbanyhighwaysigns,trafficcontroldevices,orlandscapingunlessspecificallyauthorized.

PERMITEXTENSION,ASSIGNMENT,ANDREVOCATION:

  1. ThisPermitmaynotbeextendedwithouttheDepartment’spriorwrittenapproval.
  2. ThePermitteeshallnotassignortransferthisPermitwithouttheDepartment’spriorwrittenapproval.ThePermitteeunderstandsthatanyassignmentortransferrequirestheassigneeortransfereetohavethemeanstoassumeallobligations,duties,andliabilitiesofthetermsandconditionsofthisPermit,andthePermitteeagreestoadvisetheassigneeortransfereeofitsobligationtoapplyforanupdatedorreplacementPermitfromtheDepartment.
  3. ThisPermitisgrantedsolelywithinthediscretionoftheDepartment.Itmayberevokedatwillandatanytimebygivingthirty(30)calendardayswrittennoticetothePermittee.Revocationshallautomaticallytakeeffectonthethirty-firstdaywithoutfurtheractionbytheDepartment.PermitteeacknowledgesandagreesthatithasnodueprocessorappealrightsshouldtheDepartmentdecide,foranyreasonwhatsoever,torevokethisPermit.Thereafter,ifthePermitteehasnotremoveditsfacilitiesorotherwisefailstoreturnthestatepropertybacktoitsoriginalconditionassolelydeterminedbytheDepartment,theDepartmentshallperformsuch workatthePermittee’ssolecostandexpense,andthePermitteeshallpaytheDepartment’sactualdirectandrelatedindirectcostsandexpensesforperformingtheworkpursuanttotheprovisionsofSection18-InvoiceandPayment.
  4. ShouldthePermitteebreachanyoftheconditionsorrequirementsofthisPermit,orshouldthePermitteefailtoproceedwithduediligenceandingoodfaithwiththeWorkasauthorizedbythisPermit,theDepartmentmayrevokethePermit.TheDepartmentshallgivethirty(30)calendardayswrittennoticetothePermittee,anduponthethirty-firstday,thisPermitshallbedeemedrevoked withoutfurtheractionbytheDepartment.Thereafter,ifthePermitteehasnotremoveditsfacilitiesorotherwisefailstoreturnthestatepropertybacktoitsoriginalconditionassolelydeterminedbytheDepartment,theDepartmentshallperformsuchworkatthePermittee’ssolecostandexpense,andthePermitteeshallpaytheDepartment’sactualdirectandrelatedindirectcostsand expensesforperformingtheworkpursuanttotheprovisionsofSection18-InvoiceandPayment.

DOT Form 224-698

Revised 03/2018Page 1

MODIFICATIONOFPERMITAND/ORWORK:

  1. TheDepartmentmaymodifythisPermitatanytimebygivingPermitteewrittennotice.IfthisPermitismodified,thePermitteewillhavethirty(30)calendardaysfromthedateofthewrittennoticetomodifytheWorkasrequiredbytheDepartment.Ifthemodificationscannotbemadewithinthirty(30)calendardays,thePermitteeshallrequesttheDepartment,inwriting,duringthethirty(30)calendardaytimeperiodforanextensionoftimeinwhichtomakethemodifications.Anyextensionoftimeshallbesolely withintheDepartment’sdiscretion.
  2. IfthePermitteedesirestomodifythisPermitand/ortheWork,itshallnotifytheDepartmentrepresentative(s)listedinExhibitA,SpecialProvisions,inwritingofallproposedchangesfortheDepartment’spriorapproval.TheDepartmentagreestoprovidewrittenacceptanceorrejectionoftheproposedchange(s)tothePermitteewithinTen(10)businessdays.
  3. ShouldthePermitteefailorrefusetocomplywiththeDepartment’sdirectionpursuanttosection11,theDepartmentwill implementsection10andrevokethePermit.

ADDITIONALPERMITOBLIGATIONS

  1. ThePermitteeshallnotexcavateorplaceanyobstaclewithinthestate-ownedhighwayrightofwayinsuchamannerastointerferewiththeDepartment’sconstruction,operation,andmaintenanceofthestate-ownedhighwayrightofwayorthepublic’s travelthereonwithouttheDepartment’spriorwrittenapprovaland/orasmaybeprovidedinthisPermit’sSpecialProvisions.
  2. UponcompletionofallWork,thePermitteeshallimmediatelyremoveallrubbishanddebrisfromthestate-ownedhighwayrightofway,leavingthestate-ownedhighwayrightofwayinaneat,presentable,andsafeconditiontotheDepartment’ssole satisfaction.AnyWork-relatedrubbishanddebriscleanup,oranynecessaryslopetreatmenttorestoreand/orprotectthestate-ownedrightofway,notdonewithinseven(7)calendardaysofWorkcompletion,unlesstheDepartmentapprovesotherwise,willbe donebytheDepartmentattheexpenseofthePermittee.ThePermitteeagreestoreimbursetheDepartment’sactualdirectand relatedindirectcostsandexpensesforperformingtheworkpursuanttotheprovisionsofSection18-InvoiceandPayment.
  3. ThePermitteeagreestomaintain,atitssoleexpense,itsWorkunderthisPermitinamannersatisfactorytotheDepartmentin theDepartment’ssolediscretion.
  4. IftheDepartmentdeterminesthatemergencymaintenanceoftheWorkisrequiredto(a)protectanyaspectofthestatehighwayrightofway,or(b)securethesafetyofthetravelingpublicduetoafailureofthePermittee’sWorkoritsmaintenancethereof,theDepartmentmayperformtheemergencymaintenanceworkwithoutthePermittee’spriorapproval,andthePermitteeagreestoreimbursetheDepartment’sactualdirectandrelatedindirectcostsandexpensesforperformingtheemergency maintenanceworkpursuanttotheprovisionsofSection18–InvoiceandPayment.TheDepartmentwillnotifythePermitteeoftheemergencyworkperformedassoonaspracticable.

INVOICEANDPAYMENTS

  1. IftheDepartmentperformsworkasprovidedforinthisPermitbystateforcesoritscontractor,includingbutnotlimitedtoany modification,repair,cleanuporremovaloftheWorkauthorizedunderthisPermit:
  2. TheDepartmentwillassignareimbursableaccounttothePermitteeasameansofinvoicingthePermitteeforthecostsassociatedwith thework.
  3. TheDepartmentwillprovideadetailedinvoice,includingdirectandrelatedindirectcosts,tothePermitteeforthework performedbytheDepartmentoritscontractor(s),andthePermitteeagreestopaytheDepartmentwithinfifteen(15)calendardays ofreceiptofaninvoice.
  4. ThePermitteeagreesthatifpaymentisnotmadetotheDepartmentashereinagreed,theDepartmentmaychargelatefees,interestor referthedebttoacollectionagency,allinaccordancewithWashingtonStateLaw.

ADDITIONALREQUIREDPERMITS

  1. ThePermitteeshallberesponsibleforsecuringallnecessarypermits,includingbutnotlimitedto,federal,state,andlocal regulatory,tribal,environmental,archeological,andrailroadpermitsandpermitsfromtheWashingtonStateDepartmentofEcology,theWashingtonStateDepartmentofFishandWildlife,and/ortheU.S.ArmyCorpsofEngineerspriortobeginningtheWorkauthorizedbythisPermit.ThePermitteeshallberesponsibleformitigationmeasureswherewetlandshavebeendisturbedand agreesthatitissolelyresponsibleforanyfinesimposedfornoncompliancewiththepermit(s)conditionsorforfailuretoobtaintherequiredpermits.Inaddition,thePermittee,onbehalfofitselfanditscontractors,officers,officials,employees,andagents,agrees toindemnify,holdharmless,anddefend,atitssolecostandexpense,theDepartmentanditsofficers,officials,employees,andagentsfromanyandallfines,costs,claims,judgments,and/orawardsofdamagestoregulatoryagencies,persons,and/orproperty,arisingoutof,orinanywayresultingfrom,thePermittee’sfailureto(1)obtainanyrequiredpermitforthePermitteeWorkor(2) complywithpermitconditions.
  2. ThePermitteeherebycertifiesthatitsfacilitiesdescribedinthisPermitareincompliancewiththeClearZoneGuidelinespursuanttoChapter1600oftheDepartment’sDesignManual(M22-01)andanyrevisionsthereto.

DOT Form 224-698

Revised 03/2018Page 1

INDEMNIFICATION,WAIVER,VENUE,ATTORNEYSFEES,ANDRELOCATION/EMINENTDOMAIN

  1. ThePermittee,itssuccessorsandassigns,shallindemnify,defendatitssolecostandexpense,andholdharmlesstheStateofWashington,itsofficers,employees,andagentsfromallclaims,demands,damages(bothtopersonsand/orproperty),expenses,regulatoryfines,and/orsuitsinlawandinequitythat(1)ariseoutoforareincidenttoanyactsoromissionsofthePermittee,itsagents,contractors,employees,inviteesand/oranyotherpersonintheuseofthestate-ownedhighwayrightofwayasauthorizedbythetermsandconditionsofthisPermit,or(2)arecausedbythebreachofanyofthetermsorconditionsofthisPermitbythePermittee,itssuccessorsandassigns,anditscontractors,agents,employees,inviteesand/oranyotherperson.ThePermittee,itssuccessorsandassigns,shallnotberequiredtoindemnify,defend,orholdharmlesstheStateofWashington,itsofficers,employeesand/oragents,iftheclaim,suit,oractionfordamages(bothtopersonsand/orproperty)iscausedbythesoleactsor omissionsoftheStateofWashington,itsofficers,employeesand/oragents;providedthat,ifsuchclaims,suits,oractionsresultfromtheconcurrentnegligenceof(a)theStateofWashington,itsofficers,employeesand/oragents,and(b)thePermittee,itsagents,contractors,employees,invitees,and/oranyotherpersonorinvolvesthoseactionscoveredbyRCW4.24.115,theindemnityprovisionsprovidedhereinshallbevalidandenforceableonlytotheextentoftheactsoromissionsofthePermittee,itsagents,contractors,employees,invitees,and/oranyotherperson.
  2. ThePermitteeagreesthatitsobligationsunderthisPermitextendtoanyclaim,demand,and/orcauseofactionbroughtby,or onbehalfof,anyofitsemployeesoragentswhileperformingWorkunderthisPermitwhilelocatedonoroffstate-ownedhighway rightofway.Forthispurpose,thePermittee,byMUTUTALNEGOTIATION,herebyWAIVES,withrespecttotheStateofWashingtononly,anyimmunitythatwouldotherwisebeavailabletoitagainstsuchclaimsundertheIndustrialInsuranceprovisions inchapter51.12RCW.
  3. TheindemnificationandWAIVERprovidedforinsections21and22shallsurvivetheterminationofthisPermit.
  4. IntheeventthatthePermitteeortheDepartmentdeemsitnecessarytoinstitutelegalactionorproceedingstoenforceanyrightorobligationunderthisPermit,thePermitteeandDepartmentagreethatanysuchactionorproceedingsshallbebroughtinthesuperiorcourtsituatedinThurstonCounty,Washington.Further,thePermitteeagreesthatitshallbesolelyresponsibleforitsown attorneysfeesandcostsandagreesthatitshallnotseeknorbeentitledtorecoveryofsuchattorneysfeesandcosts.
  5. NONAPPLICABILITYOFRELOCATIONASSISTANCE/EMINENTDOMAIN.ThePermitteeacknowledgesthatthisPermitdoesnotatanytimeentitlethePermittee,itssuccessorsorassigns,toassistanceundertheUniformRelocationandRealPropertyAcquisitionPolicy(ch.8.26RCW).Further,therevocationorotherterminationofthisPermitshallnotbedeemedatakingbythestateunderthelawsofeminentdomain.

DOT Form 224-698

Revised 03/2018Page 1